How to Properly Take Tamoxifen: A Breast Cancer Treatment

There are several treatment options for breast cancer, though they are typically determined by the severity of the disease when found. Hormone therapy is typically used to prevent recurrence, and according to the American Cancer Society (2015), it can be administered as the sole treatment for cancer that has returned after initial treatment. One specific drug used for hormone therapy is Tamoxifen; this post will serve as a tutorial on how to correctly take this medication.

According to “Tamoxifen,” an article published on U.S National Library of Medicine (2010), there are several steps to follow to appropriately take this medication.

1)    Tamoxifen tablets should be consumed orally. Be sure to take the pill whole. Thus, do not crush, chew, or split the pill.

2)    The pill can be taken with or without food, but water is highly recommended.

3)    Take one pill at a time, typically once or twice a day. However, this is determined by the treating physician.

4)    Follow the treatment plan as strictly as possible; therefore, remembering to take the pills each day to ensure no missed doses.

Other skills to follow appropriately utilize this medication include “[keeping] Tamoxifen in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom)” (Tamoxifen, 2010).

As with any prescription, there is an increased risk for side effects. “The most common side effects of these drugs include fatigue, hot flashes, vaginal dryness or discharge, and mood swings“ (Hormone therapy for breast cancer, 2015). If these symptoms are severe and/or persistent, it is recommended to see a physician immediately (Tamoxifen, 2010).

Works Cited

Hormone therapy for breast cancer. (2015, June 10). Retrieved July 30, 2015.

Tamoxifen: MedlinePlus Drug Information. (201, September 1). Retrieved July 30, 2015, from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682414.html 

Questions to Ask

When dealing with breast cancer, there are many questions that arise in regards to treatment and living as a survivor. Although some can be answered through electronic research, like websites and articles, there is no guarantee that the information is from reliable sources. Therefore, it is recommended that the patient utilize his or her physician, and ask questions as needed. Listed below are topics that individuals should discuss with a healthcare professional, and they are divided into sub-groups.

Prior Treatment

·      Will I be able to have children after treatment?

o   Breast cancer treatment can be very aggressive, and “certain [chemotherapy] drugs, may affect a woman’s ability to have a baby (fertility)” (Pregnancy after breast cancer, 2015). This question is typically reserved for post-treatment, when couples hope to become pregnant. However, “the best time to talk with your doctor about fertility is before starting breast cancer treatment,” as the type of treatment could be altered to avoid infertility, while also curing the disease (Pregnancy after breast cancer, 2015).

During Treatment

·      What are treatments options available for me? What about the side effects of that treatment?

o   There are several treatments available for breast cancer, though the severity of the cancer found, will determine which treatment is best. According to “The value of autonomy in medical ethics,” autonomy has taken a major role in medicine, and “it is plausible that autonomous persons are often in the best position to determine what would be good and bad for them (see, e.g., Sumner (1996)) and, consequently, it is arguable that there is good reason to consider patients’ autonomy to have instrumental value in medicine” (Varelius, 2006).  Thus, it can be concluded that it is important for the patient to be well informed about each treatment option, as well as the negative aspects, like risk of death or reoccurrence. Thus, they will be able to make a fully informed decision, which is the goal of autonomy within healthcare.

After Treatment

·      How often should I visit a physician after treatment?

o   Regardless of the severity of breast cancer, physicians will require frequent check-ups. According to “Moving on after treatment for breast cancer” (2015), these physician visits will include physical exams and discussions about symptoms. They will also require certain tests, like mammograms, blood work, and several others. “Follow-up is needed to watch for treatment side effects and to check for cancer that has come back or spread (Moving on after treatment for breast cancer, 2015).

These are typical questions that can be asked, among many. It is important for the patient to be highly involved in their health, and being adequately informed is key. Thus, as mentioned, it is recommended to ask as many questions as needed.

Works Cited

Moving on after treatment for breast cancer. (2015). Retrieved July 25, 2015, from http://www.cancer.org/cancer/breastcancer/overviewguide/breast-cancer-overview-after-follow-up

Pregnancy after breast cancer. (2015). Retrieved July 25, 2015, from http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-after-pregnancy-after

Varelius, J. (2006). The value of autonomy in medical ethics. Medicine, Health Care and Philosophy Med Health Care Philos, 377-388.

Recommendation for Family Members

Dealing with a breast cancer diagnosis can be an emotional situation for families. According to the article “Breast Cancer in Women (2015),” there are several reactions possible, all of which are actual testimonies from breast cancer survivors and their family members.

For example, one situation explained by the article represented children telling their parents about their own diagnosis. It was reported that “some […] explained that telling their elderly parents was more difficult than telling other family members, and that they did not want to worry them” (Breast Cancer in Women, 2015). The article continues by stating that the elderly parents had concern about their child suffering, while they were healthy themselves. Another example mentioned related to the family’s reaction being too overwhelming, leading the woman to hesitate associating with her family at the time (Breast Cancer in Women, 2015).  As seen, each of the examples show some type of anxiety when informing family members about their diagnosis. However, it is noted that “while family members were often shocked and upset by the news […], they were also supportive and helpful following the initial shock. Practical support was often as important as emotional” (Breast Cancer in Women, 2015).

From the article, it can be argued that reactions to a breast cancer diagnosis can vary amongst families. However, the ultimate goal would be to GAIN SUPPORT from family members. The “Breast Cancer in Women” article states that emotional support is highly valuable, as well as practical support. This can be achieved in several different ways. For example, according to “Breast Cancer in Women (2015),” some felt that their illness brought the family closer, and one woman believed her children became more compassionate and understanding of others. Another example outlined related to women with adult children, who they believe are greatly supportive, and even attempted to help the situation by seeking more information regarding the illness to assist or attending appointments (Breast Cancer in Women, 2015). Other personal examples that could be considered are taking responsibility within the household, such as, cooking and cleaning while the caregiver is being treated, or caring for younger children while the patient is in the hospital. All of these are recommendations for family members of the patient, but ultimately, they all relate to being supportive and assisting as needed.

Works Cited

Breast Cancer in Women. (2015). Retrieved July 21, 2015, from http://www.healthtalk.org/peoples-experiences/cancer/breast-cancer-women/how-it-affects-families

Self-Management of Breast Cancer

According to "Supported Self-Management,” an article published by the National Cancer Survivorship Initiative (2010), the number of those suffering from cancer or recovering has risen, with the greatest contributor being breast cancer. Thus, it can be argued that after treatment, there are many steps to take to successfully transition back into daily life. Aside from physical recovery, breast cancer survivors must focus on several other aspects on a day-to-day basis.

A topic widely discussed for breast cancer survivors is self-management. Although there are several definitions used, the review “Self-Management: Enabling and empowering patients living with cancer as a chronic illness (2015),” summarizes that it includes “tasks that individuals undertake to deal with the medical, role, and emotional management of their health condition.” Thus, due to improvements in detecting and treating cancer, many patients are living as survivors, but are responsible for their self-care following it. In addition, The National Cancer Survivorship Initiative summarized that “patient engagement in healthcare via self-management is widely [recognized] as crucial to improved outcomes for people with long-term chronic conditions (DH, 2010). With increased cancer survivorship, cancer in its chronic form, or with late consequences of treatment and co-morbidities, it is equally or even more crucial to cancer survivors.”

To complete self-management, there are several factors to consider. For example, the article “Supported Self-Management” (2010) listed the following: tailored information (to increase cancer survivors knowledge on their specific health), self –efficacy (the confidence to apply the tailored information), collaborative effort between the patient and healthcare provider (empowerment for both groups to communicate effectively), among several others as ways to correctly self-manage. Emotional support was also mentioned, which can be completed through counseling and group sessions.

Tailored information can apply to many other aspects of breast cancer recovery, including nutrition, exercise, and daily monitoring. For example, the University of California at San Francisco produced the following nutritional chart to assist breast cancer survivors. They argue that altering a diet will be a difficult lifestyle change, but it can provide a sense of well-being, while also lowering chances of recurrence or acquirement.

Recommendations	Examples
1. Lower dietary fat to between 10% to 20% of calories	Low or nonfat foods
2. Eat more plant-based protein and eat less animal-based protein	More beans and soy Less turkey and lean meats
3. Minimum daily servings of: Grains: 6 per day Vegetables: 3-5 per day Fruits: 2-4 per day Beans: 1-2 per day Soy: 1-2 per day	Whole grains Cruciferous vegetables Pinto and kidney beans Tofu and soy milk
4. Drink 8 to 10 eight-ounce glasses of water a day	Carry a water bottle
5. Limit caffeine to no more than 1 to 2 cups a day	Herbal teas
6. Drink alcohol in moderation	No more than 3 servings per week
7. Limit nitrates and cured foods	Hot dogs
8. Decrease food additives	Artificial flavors

*This chart is from the University of California at San Francisco with recommendations of how to eat healthier, as well as examples.

Although self-management is mainly related to a cancer survivor, it is definitely not limited to them. Cancer can affect anyone, and thus, it is important for every person to manage their current health on a daily basis, which could lessen the risks of acquiring the disease. This could be done in ways such as, limiting their access to known carcinogens, proper nutrition, exercise, and regular check-ups with a physician. Although these do not guarantee immunity from cancer, they do decrease the risk.

Website Links:

Breast Cancer Self-Care and Recovery: Nutrition. (n.d.). Retrieved July 30, 2015, from http://www.ucsfhealth.org/education/breast_cancer_self-care_and_recovery/nutrition/

Davies, N., & Batehup, L. (2010, March 1). SELF-MANAGEMENT SUPPORT FOR CANCER SURVIVORS: GUIDANCE FOR DEVELOPING INTERVENTIONS. Retrieved July 30, 2015.

McCorkle, R., Ercolano, E., Lazenby, M., Schulman-Green, D., Schilling, L., Lorig, K., & Wagner, E. (n.d.). Self-Management: Enabling and empowering patients living with cancer as a chronic illness. Retrieved July 30, 2015.